Do I Need a Glucose Tolerance Test with Stable Blood Sugar Levels?

Q: Do I Need a Glucose Tolerance Test with Stable Blood Sugar Levels?

Hello： In response to your question, according to the current concept of "early diagnosis and early prevention" of diabetes, if fasting blood glucose is above 100 mg/dL, it is recommended to perform an oral glucose tolerance test (OGTT). <br>If the blood glucose level exceeds 200

Blood sugar level issues?

Hello, Director Hsiao.
I have been taking the antihypertensive medication Teromin, and my fasting blood glucose levels have consistently ranged between 90 and 110 (not including 110) during health check-ups over the years.
Given this, do I need to undergo an oral glucose tolerance test? Thank you.

Mike, 60~69 year old female. Ask Date: 2007/11/13

Dr. Xiao Yongxun reply Internal Medicine

Hello: In response to your question, according to the current concept of "early diagnosis and early prevention" of diabetes, if fasting blood glucose is above 100 mg/dL, it is recommended to perform an oral glucose tolerance test (OGTT).
If the blood glucose level exceeds 200 mg/dL two hours after a meal, it may indicate diabetes.
Specifically, a fasting blood glucose level between 100-125 mg/dL is referred to as impaired fasting glucose (IFG); and if the two-hour blood glucose level during the OGTT is between 140-149 mg/dL, it is termed impaired glucose tolerance (IGT).
These two abnormal conditions can be considered as prediabetes and are often associated with hypertension, hyperlipidemia, and obesity.
They also increase the risk of cardiovascular diseases, so it is advisable to manage diet and exercise early on.
Additionally, beta-blockers (such as Tenormin) may cause insulin resistance, leading to slightly elevated blood glucose levels; it is generally recommended to use the lowest effective dose.
I suggest discussing this with your primary care physician and considering your individual circumstances before making any decisions.

Reply Date: 2007/11/13

More Info

When considering whether you need a glucose tolerance test (OGTT) despite having stable fasting blood sugar levels between 90 and 110 mg/dL, it is essential to understand the implications of your current readings and the guidelines surrounding diabetes screening.

Firstly, your fasting blood sugar levels are within a range that is generally considered normal (below 100 mg/dL) and slightly elevated (100-125 mg/dL). According to the American Diabetes Association (ADA), a fasting blood sugar level of 100-125 mg/dL is classified as "impaired fasting glucose" (IFG), which is a prediabetic condition. If your fasting blood sugar is consistently below 100 mg/dL, you are in the normal range. However, since you mentioned that your readings have been fluctuating between 90 and 110 mg/dL, it is crucial to monitor these levels closely.

The OGTT is typically recommended for individuals who have fasting blood sugar levels in the impaired range (100-125 mg/dL) or for those who exhibit symptoms of diabetes. It is also useful for diagnosing diabetes in individuals who may have normal fasting blood sugar levels but have elevated postprandial (after eating) blood sugar levels. The test involves measuring blood sugar levels before and after consuming a glucose-rich drink, allowing for a comprehensive assessment of how your body processes glucose.

Given your history of stable fasting blood sugar levels and the absence of symptoms such as increased thirst, frequent urination, or unexplained weight loss, it may not be immediately necessary to undergo an OGTT. However, if your fasting blood sugar levels consistently approach the upper limit of the normal range or if you have risk factors for diabetes (such as a family history), it would be prudent to discuss the possibility of an OGTT with your healthcare provider.

Moreover, certain medications, including antihypertensive drugs like Teromin, can influence blood sugar levels. While these medications are primarily used to manage blood pressure, they may have indirect effects on glucose metabolism. Therefore, it is essential to consider your overall health, medication regimen, and lifestyle factors when evaluating your need for further testing.

In summary, while your current fasting blood sugar levels do not necessarily warrant an OGTT, it is advisable to maintain regular monitoring and consult with your healthcare provider. They can assess your individual risk factors, review your medical history, and determine whether additional testing is necessary to ensure that you remain on track for optimal health. Regular check-ups and discussions about your blood sugar levels and any changes in your health status will help you make informed decisions about your diabetes risk and management.

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